Major complications due to transjugular liver biopsy: Incidence, management and outcome

Dohan, Anthony; Guerrache, Youcef; Dautry, Raphaël; Boudiaf, Mourad; Ledref, O.; Sirol, Marc; Soyer, Philippe

doi:10.1016/j.diii.2015.02.006

Cited by 47 publications

(40 citation statements)

References 28 publications

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“…The correlation between number of passes and rate of complication is still debated [7] , [8] . Delayed symptoms are consistent with prior reports and could be masked temporarily by the effects of analgesic medications [3] , [6] , [7] .…”

Section: Discussionsupporting

confidence: 89%

“…Several studies reviewed various major and minor complications following TJLB, namely intraperitoneal hematoma, pseudoaneurysm formation, ventricular arrhythmia, or high-grade fever [ 2 , 3 , 4 , 5 ]; however, data regarding bile leak after TJLB and its management is scarce [1] . One advantage of TJLB over percutaneous liver biopsy is to avoid capsular perforation which can lead to intraperitoneal hemorrhage particularly in coagulopathic patients which leads to increased morbidity or mortality.…”

Section: Discussionmentioning

confidence: 99%

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Bile leak after transjugular liver biopsy in a cholecystectomy patient

Alharthi

Etezadi

2018

Radiology Case Reports

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IntroductionTransjugular liver biopsy (TJLB) is a minimally invasive procedure performed to obtain hepatic tissue in patients whom standard percutaneous liver biopsy is contraindicated due to abnormal coagulation profile and/or severe ascites. Additionally, it has the advantage of simultaneously measuring the hepatic venous pressures.Case Presentation61-year-old male with history of pulmonary fibrosis, cholecystectomy and Hepatitis C underwent transjugular liver biopsy (TJLB) as part of his lung transplant workup. Shortly after the procedure, the patient developed sharp right upper abdominal pain. Immediate CT of the abdomen and pelvis showed small foci of contrast and gas in the gallbladder fossa and porta hepatis indicating hepatic capsular penetration without perihepatic hematoma or other evidence of hemorrhage. Follow up CT of the abdomen and HIDA scan confirmed the presence of bile leak. Sphincterotomy and stent placement through ERCP was performed.ConclusionBile leak after a TJLB is a rare, however, potential complication. ERCP and biliary stent seems an effective treatment for persistent symptomatic bile leak post TJLB.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Bile leak after transjugular liver biopsy in a cholecystectomy patient

Alharthi

Etezadi

2018

Radiology Case Reports

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“…Puncturerelated complications were significantly less frequent using Tru-Cut and thinner needles (19G vs. 18G) than Menghini needles, a complication that could be further reduced combining fluoroscopic and sonographic guidance. Dohan et al, 59 in a more recent case series of 331 TJLBs performed in patients with ascites and/or sever coagulopathy (defined as a prothrombin time 6 seconds longer than control time or as a PLTs count lower than 70 Â 10 3 /mm 3 ), described major complications only in 0.6% of the patients, all of them successfully treated using transcatheter arterial or venous embolization.…”

Section: Transjugular Liver Biopsymentioning

confidence: 99%

Prevention and Management of Bleeding Risk Related to Invasive Procedures in Cirrhosis

Schepis¹,

Turco²,

Bianchini³

et al. 2018

Semin Liver Dis

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Cirrhosis represents the end stage of chronic liver disease and its transition from a compensated to a decompensated status is mainly driven by portal hypertension and systemic inflammation. Although relevant modifications in the evaluation of the coagulative balance in cirrhosis across its natural history have occurred and alterations in routine indices of hemostasis have lost their role as indicators of the hemorrhagic risk of patients with liver cirrhosis, these are still perceived as prone to bleed when admitted to invasive procedures. This view, which is still present in guidelines addressing the management of bleeding risk, makes preprocedural transfusion of plasma and platelets still an ongoing clinical practice. In this review, we describe the limitations of both bleeding risk assessment in cirrhotic patients admitted to radiologic and endoscopic invasive procedures and evaluate whether preventive strategies indicated by current guidelines can affect the procedure-related hemorrhagic events.

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“…2,4 The most commonly reported major complication for transjugular liver biopsy is hemorrhage in the form of intraperitoneal hemorrhage, subcapsular liver hematoma, or hemobilia. 1,2,5 Risks of major hemorrhage from transjugular liver biopsy can be technical or patient related. Liver puncture complications have been shown to be lower with smaller needle diameter and at high volume centers.…”

Section: Discussionmentioning

confidence: 99%

Embolization of Arterial-Portal Fistula to Treat Associated Hemobilia after Transjugular Liver Biopsy

Losey

Lokken

Kolli

et al. 2020

Semin intervent Radiol

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Major complications due to transjugular liver biopsy: Incidence, management and outcome

Abstract: Major complications during TJLB are extremely rare and can be managed using arterial or venous embolization with a favorable outcome. Our results reinforce the general assumption that TJLB is a safe and well-tolerated technique.

Cited by 47 publications

References 28 publications

Bile leak after transjugular liver biopsy in a cholecystectomy patient

Bile leak after transjugular liver biopsy in a cholecystectomy patient

Prevention and Management of Bleeding Risk Related to Invasive Procedures in Cirrhosis

Embolization of Arterial-Portal Fistula to Treat Associated Hemobilia after Transjugular Liver Biopsy

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